Shelby Rose Gleason

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

162514 Issued in OH

Practice address

14574 US Highway 23
Waverly, OH 45690-9373

Phone

(740) 464-5307

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1194378315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 ZUEFLE DR",
            "city": "MC DERMOTT",
            "state": "OH",
            "postal_code": "456528935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14574 US HIGHWAY 23",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909373",
            "telephone_number": "740-464-5307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14572 US Highway 23",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "OH",
            "postal_code": "456909373",
            "country_code": "US",
            "telephone_number": "740-464-5307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "SHELBY",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "162514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Allen Gillenwater
• Angela D. Gilliland, CNP
• Robert Gillum
• Caleb Joseph Gingerich
• Kayla Renae Gleason, LPN
• Erica Lynn Glenn
• Caitlyn Goddard
• Crystal Gorman
• Matthew Gorman
• Tiffany Gorman

• Licensed Practical Nurse in Waverly, OH
• Providers in Waverly, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.